How to Talk with Teens Who are Under Stress and Facing Difficult Issues

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By Brenda Stubbs

As the parent of a teenaged boy, and a health professional who often works with teens and teaches them about physical and mental wellness, I often see and hear about – firsthand – what things our kids are stressed, depressed or anxious about. Things are so different from when I was a teenager – there were no computers, mobile phones or social media to capture every (sometimes embarrassing) move you made. Bullying wasn’t so commonplace, and it certainly couldn’t “follow you home” by way of being connected to social media 24/7. Gun violence in schools was virtually unheard of. Experiencing the death of a classmate or friend, by way of violence or suicide, was something very rare. And while peer pressure to drink, do drugs or have sex hasn’t really changed much over the years, it still somehow seemed like a kinder, simpler time back then. I often say that while I remember my high school years with a lot of fondness, I would NEVER want to be a teenager in this day and age.

Now I know many parents right now may be thinking “What?! Our kids are the most entitled generation there’s ever been!” And while it may be true that kids today have many privileges and conveniences that we didn’t have – it does NOT negate the fact that they face many stressors and traumatic experiences that many of us parents didn’t have to deal with when we were their age. For many, this is a really hard time to be a teenager in America – and as parents, we must be willing to acknowledge this and talk with our kids about hard topics, even though it can be very uncomfortable.

Research shows that our youth today suffer from depression, anxiety, and toxic stress at higher rates than ever. Let me share some statistics with you:

20-25% of teens suffer from a mental health (depression or anxiety) or substance use disorder; only about 20% get help or treatment (Mental Health in Schools: A Hidden Crisis Affecting Millions of Students; NPR Ed Series, Part One, 8/31/16)

1 in 3 teens will have experienced 2 or more traumatic events by the age of 17 (this can include but is not limited to the death of a parent, divorce, extreme bullying, being physically or sexually assaulted, or living in a home where there is domestic violence, mental illness or substance abuse. (acestoohigh.com)

Suicide is now the 2nd leading cause of death for 15-19 yr. olds (car accidents is the 1st)

From 1999 – 2014, the suicide rate for middle school girls increased by 25%

There are approx. 5,240 suicide attempts EVERY DAY in our nation by teens in grades 7-12; thankfully, the majority of those are not successful (approx. 1,748 suicides completed in 2013; boys are 3x more likely to complete suicide than girls: pediatrics.aappublications.org“Suicide and Suicide Attempts in Adolescents” June 24, 2016)

Indeed, many mental health experts believe that our teens are on the verge of the most severe mental health crisis in decades. Further, Dr. Jean Twenge – a renown clinical psychologist – and other researchers assert that social media use (and the cyber-bullying that often comes with that) is a contributing factor in – though not the cause of – the drastic rise in depression, anxiety and suicide rates in our youth. This is, in fact, the first generation of youth that has never known life without social media.

Other than the obvious, why should parents be so concerned about these alarming statistics? Because the human brain continues to develop until the age of at least 26, and we now know through years and years of research that chronic stress and trauma in childhood (<18 yrs. old) physiologically changes brain chemistry and disrupts the normal development of the brain. This affects the pre-frontal cortex, the limbic system, and impedes neural connections in our kids’ brains – which can lead to poor judgement, and poor critical thinking and coping skills. This, in turn, can manifest in more impulsive or risk-taking behaviors by our kids, putting them at higher risk for long term mental and behavioral health disorders, substance use disorders, and yes – even chronic adverse health conditions like obesity, diabetes, hypertension, and cardiovascular disease. Indeed, 50% of lifelong mental health disorders onset by the age of 14, and 70% onset by the age of 24. Going a step further to look at long term ramifications – these are all poor health conditions that kids could be experiencing as they grow into young adults and enter their prime childbearing years. And what THAT means, is that these are health problems that can affect their future birth outcomes and be passed down to the next generation. A woman who enters pregnancy with pre-existing mental health issues is much more likely to develop postpartum depression and other perinatal mood and anxiety disorders – which are, in fact, the #1 complication of pregnancy and childbirth AND a leading cause of premature birth. So, parents, we’re not only talking about your children’s health and well-being, we’re also talking about that of your future grandchildren!

So, what can we parents do? How can we spot red flags in our kids’ behavior and recognize the signs and symptoms of depression, chronic stress and anxiety? And how we can talk with our kids about these sensitive issues in a way that will keep them from shutting down or shutting us out?

Let me preface this with an interesting tidbit that you might find surprising…

In a survey of 1,843 teens conducted by Josh Shipp, a nationally known and award-winning teen expert and youth speaker, he asked them what they lie to their parents about, and here’s what they said:

31.6% reported lying/not admitting to their parents about having suicidal thoughts – the #1 thing they are hiding from us! (www.joshshipp.com)

19.6% report lying about sex

16.3% report lying about drugs

14% report lying about looking at porn

9.5 % report lying about everything

9% report lying about nothing

But is this an issue of our kids being liars, or is it a bigger issue of our kids not feeling comfortable or safe talking with us about these things – or not feeling they can be open and honest with us? I recently participated in a focus group of teen parents at a local high school, and two things stood out. All of them said that their parents never talked to them about sex or relationships and they wish they had. Secondly, they all said that they wish their parents would stop acting like they never did anything wrong or made a bad decision when they were a teenager, or that they were a perfect kid — because it just makes your kids think that YOU are lying to THEM! It’s actually good to talk with your kids about times when you were their age that you DID make a poor choice and what you learned from it. Or even telling them a traumatic experience you had as a teenager, how it affected you and how you sought help or learned to cope with your feelings. This creates an element of relatability and trust.

Remember that these conversations don’t have to be one big “TALK”, which can be traumatizing in and of itself for both you and your child. These can be small talks peppered throughout your child’s adolescent and teen years.

Here are some other helpful tips about recognizing warning signs and having difficult conversations with your kids:

How do you know the difference between your child “being in a funk” and being depressed? – Everyone has a bad day – or a few bad days – now and then, when you’re feeling out of sorts or upset. But if your child feels like that for a period of 2 weeks or more, it’s time to get them help. Some signs of depression are: a big change in appetite or sleep, wanting to isolate, a loss of interest in things that they usually like to do, having a flat “affect” or seeming hopeless. Parents may see this manifest in emotional outbursts, erractic mood swings, grades dropping, weight dropping, withdrawing from family and friends, or dropping out of activities.

Don’t be too quick to dismiss mood swings or emotional outbursts as “hormonal”, “just a phase”, or “typical teenage behavior” – downplaying or missing the warning signs above can have detrimental effects for your child. Depression can be an insidious disease – it is not something to take lightly, and there is absolutely no shame in getting help.

Instead of asking “What’s wrong with you?!” ask “What happened to you?” – the first is more accusatory and can cause your child to shut down/clam up; the second is more supportive and can invite more discussion – i.e. “What happened to you today/this week/this year that is making you feel sad/anxious/angry? How can I help you work through this?”

Trauma is all about PERCEPTION! – i.e. if your child went through a bad break-up, or has been bullied at school or online, or maybe they didn’t make the athletic team they tried out for, or they didn’t get into the college they wanted to — even though it may not seem “traumatic” to you, it could, in fact, be traumatic to them. THEIR perception is THEIR reality.

Let’s talk about sex and relationships: You can clearly state to your children what your beliefs are around sex and healthy relationships, but try not be judgmental or “push” your beliefs on them. Again, this could be an appropriate time to share with them what your experiences were when you were their age, or even when you were older. Help your kids understand their own bodies and how they function, what personal boundaries are, and teach them about consent in a sexual relationship; no one has a right to touch them without their permission. Help them understand the more subtle forms of abuse – that in addition to physical or sexual abuse, there can also be emotional or verbal abuse – where the scars may not be visible, but can run just as deep and for a very long time. Perhaps most importantly, model healthy communication and respect in your own relationships! Our kids are often watching and listening, even when it seems like they aren’t.

And by the way, research shows that:

Teaching “abstinence only” does NOT work

Providing condoms or other contraception to teens does NOT increase the likelihood of them engaging in sex if they weren’t planning to

Talking to kids about suicide does NOT make them feel suicidal if they weren’t in the first place

Talking to teens, especially boys, about “sensitive topics” can be challenging – experts say: 1)it is hard for them to make eye contact (so don’t always insist on it, and realize that most of the time, even if they aren’t looking at you, they ARE listening to you!) 2) teens often need something to “fidget with” or have something to do with their hands to make them feel more comfortable (ok to insist they put their phone down or turn off the TV/game, but let them have a fidget spinner or a stress ball or a pencil to twirl during the conversation because, psychologically, that can “distract” them from the uncomfortableness they may feel, while still allowing them to pay attention to the conversation)

Remember that your kids may not be ready/willing to talk at the same time you are, even though they may WANT to talk with you. Sometimes you just need to open the door for a conversation – ex. “It seems like you are upset about something” or “You don’t seem like yourself today. Is there anything you want to talk about?” If answer is no, simply say “Ok, well just know I love you and I’m here to listen if and when you want to talk.” Then be patient, and wait. Often they will come to you later ready to talk, and when they do, be prepared to stop what you are doing and LISTEN, just like you said you would do.

Use movies, TV shows, events in the news as teachable moments – there are often plot lines or news stories that can be used a great opportunity to dialogue with your kids. Good examples are – “What do you think about that?” “What do you feel when you hear about something like this?” “Are things like this happening in your school or within your circle of friends?” “How would you handle that situation?” One important caveat here is to be careful about overexposure to traumatic or scary events in the news or on social media; for example – constant coverage of school shootings or of fatal car accidents involving teens. There comes a point where constant exposure can actually cause secondary PTSD in our kids and cause them to become overly fearful and anxious, or even develop phobias. But again, you need to be talking with them about this if you see cause for concern.

One final, but very important note … research out of Harvard University shows that “Every child who winds up doing well has had at least ONE stable and committed relationship with a supportive adult!” Never underestimate the power and benefit of your child having at least ONE ADULT MENTOR in their lives that they can go to or talk to about anything, and feel safe doing so. These kids stay on the right path to achieve more of their goals, and ultimately do better in life. Now, I’m going to say something that parents might find a little hard to swallow:

Try not to be offended if you’re not their “go-to” adult when they want to talk – if they are confiding in a teacher/coach/counselor/minister/relative, etc., the important thing is that they ARE talking to an adult, who can guide them through tough situations and assist them in seeking help. In addition, another responsible adult (as opposed to a peer) is more likely to encourage your child to open up to you, as well.

To quote teen expert Josh Shipp, “Every kid is ONE bad decision away from becoming a statistic, and ONE caring adult away from being a success story.” Parents who are informed about the “current state” of our teens, and who have open, honest and continuous conversations with their kids about the tough topics are more likely to prevent the former and foster the latter.

National Suicide Prevention Hotline: 800-273-8255

Teen Crisis Text Line: text “HELP” to 741741

Brenda Stubbs is a health professional who has worked in health and human services for 22 years, and specifically in maternal and child health for 16 yrs. She is professionally trained in Youth and Adult Mental Health First Aid, Maternal Mental Health, Adverse Childhood Experiences (ACE) and Resiliency, and Perinatal Mood and Anxiety Disorders. She currently serves as Regional Program Coordinator for the March of Dimes’ NC Preconception Health Campaign. Brenda is also the parent of a 16-year-old old boy who has struggled with depression and anxiety for much of his life and consequently is a strong advocate for youth mental health.